HIGHLIGHTS

NFID Releases New Resources on Influenza Immunizations of Those with Chronic Illness

The National Foundation for Infectious Diseases (NFID) is pleased to share a new online toolkit developed to increase awareness about the dangers of influenza in US adults with chronic health conditions and the importance of annual vaccination.

Influenza (flu) is a contagious and potentially deadly virus that can result in serious complications for individuals living with certain chronic health conditions such as heart disease, lung disease, and diabetes, even when the conditions are well-controlled. Estimates indicate that 31 percent of US adults age 50–64 and 47 percent of those age 65 and older have at least one chronic health condition that puts them at high risk for flu-related complications, including hospitalization, catastrophic disability, and even death.

NFID urges you to take a few minutes to review these important new tools and to share them widely with your colleagues and stakeholders. Note that the resources are all free of charge and are available on the NFID Flu and Chronic Health Conditions webpage, including:

The webpage includes posts, images, and website/newsletter content. Customizable sample social media posts can be used to share the resources, such as:

Adults with chronic health conditions are at high risk for complications from #flu, including permanent physical disability & death. Learn about what you can do to help #FightFlu at www.nfid.org/flu #GetVaccinated

#DYK: #Flu can be deadly for people with heart disease? They are 10X more likely to have a heart attack within 3 days of flu infection. Learn more about what you can do to help #FightFlu at www.nfid.org/flu #GetVaccinated

Be sure to follow NFID on Twitter and Facebook and share flu-related posts with the hashtag #FightFlu.

CDC developed additional tools in response to increased reports of SIRVA (Shoulder Injuries Related to Vaccine Administration) to the Vaccine Injury Compensation Program, including an infographic that can be placed in clinics, pharmacies, offices, and other sites where vaccine is being administered and a vaccine administration website that consolidates related resources.

Cooperative Agreement Grants Open at CDC

The following cooperative agreement grants are open for application at the CDC. Please check them out:

CDC Influenza Webinar on December 5 for National Influenza Vaccination Week

Last year, we saw striking drops in flu vaccination coverage. We need everyone to help Fight Flu. As an important partner, we are asking for your support to increase flu vaccination rates this year — A strong recommendation from a health care professional makes a difference!

In recognition of National Influenza Vaccination Week (NIVW), please save the date for the Center for Disease Control and Prevention’s webinar #HowIRecommend Flu Vaccine: How to Make Recommendations that Matter to Patients on Wednesday, December 5, 2018, 1–2 pm EST to learn more about how to make a strong vaccine recommendation and strategies to address questions from patients. Featuring representatives from CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) and practicing professionals like yourself, this webinar will provide you with the tools you need.

Cornerstone Government Affairs is pleased to provide their 2018 Election Analysis for the Summit partners. The analysis provides a breakdown of federal and state election results from around the country along with analysis and implications across a wide range of policy areas.

AIRA’s Assessment Steering Committee (ASC) is launching a new data quality project focusing on patient status. The purpose of this project is to bridge the gap between currently published guidance on patient status and its actual implementation by IIS and EHRs. This project aims to bring together IIS, EHR, and providers stakeholders to develop implementation guidance on 1) proper usage of all the fields that can and should be used for messaging and interpretation of patient status, 2) development of an appropriate plan/algorithm for the appropriate inactivation of patients (while ensuring this plan does not conflict with AFIX/IQIP guidance), and 3) development of appropriate provider and jurisdiction level workflows to manage this data. Patient status management will include how the data should best be entered, messaged, received, processed, and stored not only from the IIS perspective but also from the EHR and provider perspective as well.

At this time, the ASC is requesting any written materials your IIS or EHR has developed around patient status management (i.e., presentations, policies, protocols, and/or workflows for capturing/interpreting this data). AIRA is requesting materials be sent to Nichole Lambrecht, preferably by November 30, 2018.

There has been an unprecedented level of demand for SHINGRIX from patients and health care professionals (HCPs). GSK has responded to this demand by significantly increasing and accelerating shipments of SHINGRIX this year. As of the end of Q3 2018, nearly 7 million doses of SHINGRIX have been administered globally since launch. The vast majority of the vaccine was administered in the US. We have also established a reliable and consistent shipping schedule – shipping product every 2–3 weeks – to help establish predictability of supply and inform customer planning. Wholesalers and distributers have been notified that they can expect shipments on this schedule for the remainder of 2018.

For 2019, GSK will significantly increase the number of doses available; however, we anticipate that demand for SHINGRIX will continue to outpace supply.

GSK is working to ensure that the vaccine is available to individuals who are indicated to receive it. We will continue to increase production to meet demand and will provide proactive educational outreach and supply updates to HCPs and other stakeholders.

SHINGRIX is a vaccine indicated for the prevention of herpes zoster (shingles) in adults aged 50 years and older. SHINGRIX is not indicated for prevention of primary varicella infection (chickenpox).

Two doses (0.5 mL each) are administered intramuscularly according to the following schedule: A first dose at month 0 followed by a second dose administered anytime between 2 and 6 months later.

During this period of SHINGRIX ordering limits and intermittent shipping delays, every effort should be made to complete the 2-dose series as directed. The clinical benefit of preventing shingles demonstrated in the clinical trials of SHINGRIX was observed with the 2-dose series. In the case that a patient is unable to receive the second dose between 2 and 6 months after the first dose, the CDC has provided the following guidance: “If more than 6 months have elapsed since the first dose, administer the second dose as soon as possible. You should not restart the vaccine series. However, the efficacy of alternative dosing regimens has not been evaluated, data regarding the safety of alternative regimens are limited and individuals might remain at risk for herpes zoster during a longer than recommended interval between doses 1 and 2.”

In a phase 3 clinical study designed to help establish the dosing interval for SHINGRIX, all primary endpoints were met for dosing at a 0- and 6-month interval when compared to dosing at a 0- and 2-month interval. However, a co-primary endpoint (noninferiority) of the immune response was missed for dosing at a 0- and 12-month interval. (The upper limit of the 97.5% confidence interval was 1.53, above the predefined limit of <1.5.)

GSK is dedicated to educating patients and providers about the 2-dose series and facilitating timely series completion. Our allocation of new SHINGRIX doses supports second dose completion. GSK also has programs in place to support series completion, and these programs show good outcomes as the result of healthcare partnerships and provider and patient education.

ANNOUNCEMENTS

Available On-line; Six Training Sessions to Help Implement Standing Orders Protocols (SOPs) for Adult Immunization

Looking for an evidence-based method to help increase adult immunization rates? Wondering about using SOPs but don’t know where to start? The content for this comprehensive six-part series available online 24/7 will help your healthcare setting implement SOPs for adult immunizations. Speakers include immunization experts Drs. Deborah Wexler, William Atkinson, and Litjen Tan. Attending this series does not earn Continuing Education (CE) credit. The series is developed and provided by IAC, IDCareLive, and Pfizer.

Registration is free but is required in order to view any session. The link will bring up a short registration form to create a free IDCareLive account, if you don’t already have one. After signing up, you will be transferred directly to the intended page.

NACCHO Releases 2018 Forces of Change Report

NACCHO has released the 2018 Forces of Change report highlighting new findings on the forces that are affecting the nation’s local health departments (LHDs). Results show that although the economic situation is slowly improving for many LHDs, workforce capacity challenges persist. One-third of LHDs reported experiencing job losses in 2017. LHDs also faced with challenges associated with emerging public health threats, such as the use of opioids, increased severity of influenza seasons, and impacts of climate change. LHDs are adapting to these changing priorities by shifting towards a population health approach. For example, many LHDs reported addressing issues related to food insecurity, family supports, and community infrastructure. An additional factor supporting public health transformation is informatics capacity, which enables LHDs to collect, analyze, and communicate data across health systems to effectively respond to the dynamic health needs in their communities.

2019 ACVR Registration & Abstract Submission Site Now Open

Plan to join the National Foundation for Infectious Diseases (NFID) at the 2019 Annual Conference on Vaccinology Research (ACVR) scheduled for April 3–5, 2019 in Baltimore, MD. Meet with colleagues from around the world at this can’t miss event!

CDC Launches “Journey of Your Child’s Vaccine” video

CDC recently launched a new video for parents that takes viewers on the journey of a childhood vaccine from development through safety monitoring after a vaccine is licensed and introduced in the population. The 5-minute video explains the three phases of clinical trials, vaccine manufacturing, and how a vaccine is added to the U.S. recommended immunization schedule. Please share the video with parents and link to it from your website and social media channels.

New 65+ Flu Defense Website Features Tools and Resources for Healthcare Professionals Serving Adults Age 65 and Older

Annual influenza vaccination is the best way to prevent influenza, but vaccination coverage among older adults in the U.S. has stagnated, and in some years has declined significantly over the previous season’s rate. In the 2016–2017 season, only 65.3% of adults age 65 and older were vaccinated against the flu.

However, seniors are at greater risk of severe complications from influenza, due both to their increased likelihood of having chronic conditions and to the decline of their immune systems with aging.

As a healthcare provider (HCP), your strong, confident recommendation for flu vaccine is a very powerful and persuasive tool in determining if your patients are vaccinated. To assist you in this effort, the new 65+ Flu Defense website has been launched. This project, a collaboration between IAC and Seqirus, aims to reach HCPs with information, tools, and resources they need to better communicate the impact of flu and its complications in older adults, and to proactively discuss flu vaccination with their patients age 65 and older.

NIVW Resources Available

NEWS

CDC Influenza Updates

The Influenza Surveillance Report (FluView) for Week 46 ending November 17, 2018 is on CDC’s website.

Here is a synopsis of the latest FluView:

Influenza activity in the United States remains low, although small increases in activity were reported. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B viruses continue to co-circulate, with influenza A(H1N1)pdm09 viruses reported most commonly by public health laboratories since September 30, 2018. Below is a summary of the key influenza indicators for the week ending November 17, 2018:

Viral Surveillance: Influenza A viruses have predominated in the United States since the beginning of July. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was low.

Virus Characterization: The majority of influenza viruses characterized antigenically and genetically are similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses.

Antiviral Resistance: All viruses tested since late May show susceptibility to the antiviral drugs oseltamivir, zanamivir, and peramivir.

Influenza-like Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) remained at 1.9%, which is below the national baseline of 2.2%. Two of 10 regions reported ILI at or above their region-specific baseline level.

ILI State Activity Indictor Map: Three states experienced moderate ILI activity, New York City and eight states experienced low ILI activity; the District of Columbia and 39 states experienced minimal ILI activity; and Puerto Rico had insufficient data.

Geographic Spread of Influenza: The geographic spread of influenza in one state was reported as regional; Guam and 14 states reported local activity; and the District of Columbia, Puerto Rico, the U.S. Virgin Islands and 35 states reported sporadic activity.

Pneumonia and Influenza Mortality:The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.

One-third of U.S. Parents Plan to Skip Flu Shots for Their Kids This Season

Thirty-four percent of US parents said their child was unlikely to get the flu vaccine this year, according to a report published by C.S. Mott Children’s Hospital.

The online poll, which was administered in October, looked at 1,977 parents who had at least one child, whether parents would get their children the flu vaccine and their reasoning, among other things.

Of parents polled, 48% said they usually followed the recommendations of their child’s health care provider when making choices about the flu vaccine. However, 21% of those surveyed did not remember their health care provider making a recommendation about their child receiving the flu shot.

Chickenpox Outbreak at School Linked to Vaccine Exemptions

At least three dozen students have come down with chickenpox at a private school in North Carolina — nearly one-quarter of the student body — in what health officials call the largest outbreak in the state since the chickenpox vaccine became available more than two decades ago.

The students, who range in age from 4 to 11 years old, attend the Asheville Waldorf School in Asheville, N.C., about 120 miles west of Charlotte. They began falling ill in mid-September, said Dr. Jennifer Mullendore, the medical director for Buncombe County Health & Human Services. The school has 152 children in nursery school through sixth grade, and one of the state’s highest rates of religious exemptions for vaccination.

An article about the outbreak has been published in the New York Times.

Massachusetts’ Largest Health System Requires Employees to Get Flu Shots

GoFundMe Campaign Hopes to Deliver Vaccines to the Most Vulnerable

As we approach the month of December, the season of giving is upon us. People around the world are preparing for their winter holiday and gift giving to friends and families. In an effort to play into the season, a GoFundMe campaign was initiated to help UNICEF deliver vaccines to people around the world. The campaign titled, “UNICEF Donation,” hopes to raise $1500 to help the most vulnerable individuals receive life-saving vaccinations. A news story is available online.

Meningitis Outbreak at SDSU Appears Stalled

San Diego State University has not seen any more meningococcal disease cases since an outbreak was declared on Sept. 28, suggesting that an undergraduate-focused vaccination campaign on campus is doing its job. Many of the SDSU students who stood in long vaccination lines on campus in late September and early October are returning to student health services to get their second doses as education and awareness efforts continue, said Andrea Dooley, the university’s associate vice president for student affairs.

“We are continuing to have the conversation about risk factors as we’re pushing out our second-dose campaign,” Dooley said.

The State of Vaccine Confidence

On Oct 17, 2018, WHO reported 52,958 measles cases in the European region since the beginning of 2018, which is more than double the 23,757 cases reported for Africa in the same period. The USA reported about 80,000 influenza deaths and a record high of over 950,000 influenza-related hospital admissions during the winter of 2017–18. Overall, seasonal influenza vaccination coverage in the USA in adults was only 37·1%, 6·2% lower than the 2016–17 season.

The Lancet contains Heid Larson’s most recent evaluation. The full text is free, but registration is required.

Three Slide Decks Available to Support New Standards for Adult Immunization Practice

The Summit’s Access and Collaboration workgroup has developed three separate slide decks with talking notes to support partners and others who wish to present on the Standards to their peers and colleagues. The three audiences targeted by the decks are: healthcare providers; patients/public; and public health. These are now available, along with tips and tools on how to use them, at the Summit website.

Also, do not forget that Medscape has produced two modules to support the implementation of the Standards:

Summit Website Offers Wonderful Resources on Influenza Vaccination

Remember to visit the Summit website for the latest on influenza immunization resources. You also can find archived copies of The Summit Buzz there.

REMINDER

Summit calls are held weekly on Thursday at 3 pm ET throughout the influenza season unless cancelled. Call information and an agenda generally are sent the morning of the call. Call summaries are available shortly after each call on the Summit website.

Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.